Until you've experienced it yourself, it may seem contradictory that a person can be utterly exhausted and yet unable to sleep, but that's precisely what distinguishes insomnia from other sleep disorders.
Conditions such as sleep apnea and narcolepsy, or just regular sleep deprivation, cause excessive daytime sleepiness; people will nod off while doing normal daytime activities such as driving or sitting at a desk.
But with chronic insomnia, people can't sleepat least not long and deep enough to keep their bodies and minds functioning at 100%.
Jo Dickison, 38, has battled insomnia since a stressful family conflict in 2003. Today she switches back and forth between prescription meds, and has tried cognitive behavioral therapy, psychotherapy, better sleep hygiene, and giving up caffeine over the years, but sometimes she still spends weeks sleeping less than four hours a night. Yet she never feels sleepy during the day, just worn out.
"People don't get it," she says. "I can't nap; I wish I could. I get fatigued and too tired to do things like go out to dinner with friends. Not because I'm afraid I'll fall asleep, but because I just can't deal with socializing and putting out the extra effort."
Personal relationships are often hard hit when a person experiences chronic sleep deprivation. Rebecca Wiseman, 26, developed insomnia while pregnant with her second set of twins. Even since her babies began sleeping soundly, the stay-at-home mom still lies awake most nights.
"I'm tired and get headaches all the time, which my doctor says is caused by my lack of sleep," says Wiseman, who lives in Sumter, S.C. "I don't have the energy that I used to, to play with my older girls, and it causes stress between my husband and me. We seem to argue more often about very stupid issues, on things like sweeping or laundry."
Because sleep deprivation takes such a heavy toll, both physically and emotionally, it can increase your risk of depression, alcoholism, and other health problems. Talk to your doctor about sleep hygiene, medication, or therapy, if you're not sleeping as well as you should be.